Phacoemulsification without hydroprocedure: A novel technique to deal with posterior polar cataracts

The purpose of the study was to describe a new phacoemulsification technique without hydroprocedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rupture (PCR) and postoperative outcomes.

We conducted a retrospective study with 115 eyes of 77 patients. After capsulorhexis, we insert the phaco tip inside the eye and do shaving of the cortex and epinucleus within the capsulorhexis area. The tip of the phacoemulsification probe is buried deep into the center of the nucleus and a anterior-poserior crack is fashioned. Then, the tip is placed at 7 o'clock position to chop away a triangular piece of the nucleus. A similar maneuver is done at 4 o'clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the two instruments, the fragments are now pushed away and easily emulsified.

The mean age of the study population was 51.87 ± 14.19 years (range: 22-87 years). Of 77 patients, 39 (50.64%) patients had unilateral PPC and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%), among them two patients had fragment drop and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32-20/80 was in 11 (9.56%) eyes, and BCVA 20/80-20/200 was in 2 (1.73%) eyes.

Phacoemulsification without hydroprocedure is a novel technique that can be successfully implemented in cases of PPC and can expect an excellent visual outcome.